Untutored training pathway to achieve competence in esophagogastric endoscopic submucosal dissection in a Western center.

Background And Aims: Endoscopic submucosal dissection (ESD) has a long learning curve. The aim of this study was to assess the efficacy of an ESD unsupervised training model for experienced endoscopists.

Methods: Stepwise training included a visit to a high-volume center, unsupervised training on an ex vivo porcine model, and in vivo human upper GI cases with anatomic progression.